Spirulina

ACE inhibitorsACE inhibitors: The IC50 values for angiotensin-converting enzyme (ACE) inhibitory activity were lowest in five (out of 48 tested) materials, including Spirulina platensis, suggesting that spirulina may contain beneficial materials for the production of ACE inhibitory peptides by proteolysis (70).

Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In laboratory research, C-phycocyanin was shown to be an inhibitor of platelet aggregation, which, according to the investigators may be associated with mechanisms including the inhibition of thromboxane A2 formation, intracellular calcium mobilization, and platelet surface glycoprotein IIb/IIIa expression, accompanied by increasing cyclic AMP formation and platelet membrane fluidity (17).

AntihistaminesAntihistamines: Theoretically, spirulina may have additive effects when taken with antihistamines. Spirulina has been shown to inhibit IgE-mediated histamine release from activated mast cells in rats, preventing anaphylactic reactions after exposure with a known allergen (10). A study in subjects with allergic rhinitis demonstrated efficacy of spirulina for improving symptoms of allergic rhinitis (4).

Antihypertensive agentsAntihypertensive agents: The IC50 values for angiotensin-converting enzyme (ACE) inhibitory activity were lowest in five (out of 48 tested) materials, including Spirulina platensis, suggesting that spirulina may contain beneficial materials for the production of ACE inhibitory peptides by proteolysis (70). In human research, treatment with spirulina decreased blood pressure (49).

Antineoplastic agentsAntineoplastic agents: Spirulina may have additive effects when taken with antineoplastic agents. In vitro and animal studies suggest that spirulina may have anticancer effects (16; 15; 108; 109). Spirulina has demonstrated protective effects against cyclosporine- and cisplatin-induced nephrotoxicity in rats through its antioxidant properties (41; 110; 39). Pretreatment with spirulina or C-phycocyanin significantly protected rats and mice from doxorubicin-induced cardiotoxic effects, as evidenced by lower mortality, fewer ascites, lower levels of lipid peroxidation, the normalization of antioxidant enzymes, ultrastructural studies showing minimal damage to the heart, increases in the expression of Bax protein, the release of cytochrome c, and increases in the activity of caspase-3 in cells (21; 22). Animal research reported protective effects of spirulina in relation to cyclophosphamide-induced genetic damage to germ cells (111).

Antiobesity agentsAntiobesity agents: In vitro research on ethanolic extracts of Spirulina maxima showed inhibited synthesis and release of a cyclooxygenase-dependent vasoconstrictor metabolite of arachidonic acid, which is increased in obesity (29).

Antiviral agentsAntiviral agents: Spirulina may have additive effects when taken with antivirals. Polysaccharides found in Arthrospira platensis (formerly known as Spirulina platensis) inhibited both herpes simplex virus type 1 (HSV-1) and human immunodeficiency virus type 1 (HIV-1) in vitro and in animals (112; 28). Spirulina supplements have been studied in HIV patients. A decreased incidence of opportunistic pneumonia infections (85) and increased insulin sensitivity have been observed (64). In a study with chronic hepatitis C patients, supplementation with spirulina demonstrated a lack of virologic response (83).

Appetite suppressantsAppetite suppressants: In in vitro research, ethanolic extracts of Spirulina maxima inhibited the synthesis and release of a cyclooxygenase-dependent vasoconstrictor metabolite of arachidonic acid, which is increased in obesity (29).

Athletic performance enhancersAthletic performance enhancers: In human research, treatment with spirulina resulted in significantly increased time to fatigue following a two-hour run (47). In other human research, Spirulina platensis showed a preventive effect of the skeletal muscle damage that, according to the authors, may have led to postponement of the time of exhaustion during the all-out exercise (23).

Cardiovascular agentsCardiovascular agents: Theoretically, spirulina may have additive effects when taken with ACE inhibitors. According to in vitro research, spirulina may contain beneficial constituents for the production of ACE inhibitory peptides by proteolysis (70).

CisplatinCisplatin: Spirulina has demonstrated protective effects against cyclosporine- and cisplatin-induced nephrotoxicity in rats through its antioxidant properties (41; 110; 39).

CyclosporineCyclosporine: Spirulina has demonstrated protective effects against cyclosporine- and cisplatin-induced nephrotoxicity in rats through its antioxidant properties (41; 110; 39).

Cytochrome P450-modifying agentsCytochrome P450-modifying agents: In animal research, gastric intubation with spirulina suspension for 15 days led to a decrease in the hepatic content of cytochrome P450 enzymes and an increase of glutathione S-transferase activity (45). Theoretically, spirulina may interact with other cytochrome P450-modifying agents.

DoxorubicinDoxorubicin: In animal research, spirulina served as a cardioprotective agent during doxorubicin treatment (22). Additionally, with Spirulina, there was a lack of interference with the antitumor activity of doxorubicin; the authors stated that, consequently, spirulina may improve the therapeutic index of doxorubicin (22).

Drugs used for osteoporosisDrugs used for osteoporosis: Theoretically, spirulina may decrease the effectiveness of drugs used to treat osteoporosis. Spirulina decreased bone mineral density in the trabecular bone of rodents under estrogen-deficient conditions; however, the exact mechanism was unclear (65).

Gastrointestinal agentsGastrointestinal agents: In animal research, Spirulina maxima in the diet increased the amount of fat in the feces; reduced plasma, liver, and heart alpha-tocopherol levels; and increased liver retinoid levels at low concentrations (113). Spirulina platensis has been shown to stimulate the in vitro growth of lactic acid bacteria, which may explain the use of spirulina as a digestive aid (114). In animal research, gastric intubation with spirulina suspension for 15 days led to a decrease in the hepatic content of cytochrome P450 enzymes and an increase of glutathione S-transferase activity (45). Reports of laboratory research stated that polysaccharides derived from spirulina may function as a potential antiadhesive agent against H. pylori colonization of gastric mucin (25).

Hepatic agentsHepatic agents: Carotenoids extracted from Spirulina platensis and Dunaliella salina have been proposed to have hepatoprotective activity (27). Selenium-rich Spirulina platensis has displayed antagonistic effects to liver fibrosis, which may suggest that enhancement of antioxidation levels and liver reserve function might be associated with these effects (20).

ImmunostimulantsImmunostimulants: There is evidence from animal research that spirulina may have an immune-enhancing effect and theoretically may interfere with immunosuppressive therapy (62). A study in mice demonstrated that Spirulina fusiformis 400 or 800mg/kg of body weight significantly decreased immune response. An in vitro study carried out by the same investigators demonstrated that 50 or 100mcg/mL of Spirulina fusiformis inhibited mitogen (phytohemagglutinin)-induced proliferation of T lymphocytes (115). A pilot study followed by a randomized controlled trial by the same investigators assessed the effects of spirulina on immune function and reported an increase in natural killer (NK) cell activity (86). In human research, treatment with spirulina caused a significant increase in IL-2 and a slight but statistically insignificant change in IL-6 (48).

ImmunosuppressantsImmunosuppressants: There is evidence from animal research that spirulina may have an immune-enhancing effect and theoretically may interfere with immunosuppressive therapy (62). A study in mice demonstrated that Spirulina fusiformis 400 or 800mg/kg of body weight significantly decreased immune response. An in vitro study carried out by the same investigators demonstrated that 50 or 100mcg/mL of Spirulina fusiformis inhibited mitogen (phytohemagglutinin)-induced proliferation of T lymphocytes (115). A pilot study followed by a randomized controlled trial by the same investigators assessed the effects of spirulina on immune function and reported an increase in natural killer (NK) cell activity (86). In human research, treatment with spirulina caused a significant increase in IL-2 and a slight but statistically insignificant change in IL-6 (48).

Neurologic agentsNeurologic agents: Spirulina maxima may have a neuroprotective role. In animal research, spirulina partially prevented the dopamine-depleting effect of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and blocked oxidative stress in a model of Parkinson's disease (43). A study using a combination herbal product that included Spirulina platensis demonstrated an improvement in attention in ADHD patients; however, the effect of spirulina alone was unclear (68). In human research, supplementation with Klamath algae decreased the menopausal symptoms of anxiety, depression, and somatization (89).

Ophthalmic agentsOphthalmic agents: It has been claimed that super blue-green algae may improve eyelid and facial spasms; however, the mechanism of action is unknown. Preliminary research from one randomized, double-blind, placebo controlled trial found that taking super blue-green algae for six months lacked efficacy in reducing eyelid spasms in people with blepharospasm (84).

Photoprotective agentsPhotoprotective agents: In human research, photolyase (from Anacystis nidulans) with sunscreen prevented apoptosis and cyclobutane-type pyrimidine dimer creation more effectively than sunscreen alone (117). A study in 14 patients with polymorphic light eruption (PLE) demonstrated that use of a sunscreen lotion made with Anacystis nidulans led to fewer PLE symptoms after UV light exposure (118).

Sleep inducersSleep inducers: One trial reported that spirulina in a dose of 3g daily lacked benefit over placebo for treatment of fatigue and possibly lacked an effect on chronic fatigue (82).

Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In laboratory research, C-phycocyanin was shown to be an inhibitor of platelet aggregation, which, according to the investigators, may be associated with mechanisms, including the inhibition of thromboxane A2 formation, intracellular calcium mobilization, and platelet surface glycoprotein IIb/IIIa expression, accompanied by increasing cyclic AMP formation and platelet membrane fluidity (17).

AntihistaminesAntihistamines: Theoretically, spirulina may have additive effects when taken with antihistamines. Spirulina has been shown to inhibit IgE-mediated histamine release from activated mast cells in rats, preventing anaphylactic reactions after exposure with a known allergen (10). A study in subjects with allergic rhinitis demonstrated efficacy of spirulina for improving symptoms of allergic rhinitis (4).

AntihypertensivesAntihypertensives: The IC50 values for angiotensin-converting enzyme (ACE) inhibitory activity were lowest in five (out of 48 tested) materials, including Spirulina platensis, suggesting that spirulina may contain beneficial materials for the production of ACE inhibitory peptides by proteolysis (70). In human research, treatment with spirulina decreased blood pressure (49).

AntineoplasticsAntineoplastics: Spirulina may have additive effects when taken with antineoplastic agents, because in vitro and animal studies suggest that spirulina may have anticancer effects (16; 15; 108; 109). Spirulina has demonstrated protective effects against cyclosporine- and cisplatin-induced nephrotoxicity in rats through its antioxidant properties (41; 110; 39). Pretreatment with spirulina or C-phycocyanin significantly protected rats and mice from doxorubicin-induced cardiotoxic effects, as evidenced by lower mortality, fewer ascites, lower levels of lipid peroxidation, the normalization of antioxidant enzymes, ultrastructural studies showing minimal damage to the heart, increases in the expression of Bax protein, the release of cytochrome c, and increases in the activity of caspase-3 in cells (21; 22). Animal research reported protective effects of spirulina in relation to cyclophosphamide-induced genetic damage to germ cells (111).

Antiobesity agentsAntiobesity agents: In vitro research on ethanolic extracts of Spirulina maxima showed inhibited synthesis and release of a cyclooxygenase-dependent vasoconstrictor metabolite of arachidonic acid, which is increased in obesity (29).

AntioxidantsAntioxidants: Spirulina contains phenolic acids, tocopherols, and beta-carotene, which are known to exhibit antioxidant properties (119). Spirulina provides some antioxidant protection for both in vitro and in vivo systems (119). A study in runners demonstrated that spirulina decreased carbohydrate oxidation and fat oxidation (47). In human research, spirulina was reported to significantly decrease thiobarbituric acid reactive substance (TBARS), as well as significantly increase total antioxidant status (TAS) and plasma superoxide dismutase (SOD) activity (48; 23). In other human research, treatment with spirulina significantly decreased carbohydrate oxidation and modulated increase in TBARS during exercise.

AntiviralsAntivirals: Theoretically, spirulina may have additive effects when taken with antivirals. Polysaccharides found in Arthrospira platensis (formerly known as Spirulina platensis) inhibited both herpes simplex virus type 1 (HSV-1) and human immunodeficiency virus type 1 (HIV-1) in vitro and in animals (112; 28). Spirulina supplements have been studied in HIV patients. A decreased incidence of opportunistic pneumonia infections (85) and increased insulin sensitivity have been observed (64). In a study with chronic hepatitis C patients, supplementation with spirulina demonstrated a lack of virologic response (83).

Appetite suppressantsAppetite suppressants: In in vitro research, ethanolic extracts of Spirulina maxima inhibited the synthesis and release of a cyclooxygenase-dependent vasoconstrictor metabolite of arachidonic acid, which is increased in obesity (29).

Athletic performance enhancersAthletic performance enhancers: In human research, treatment with spirulina resulted in significantly increased time to fatigue following a two-hour run (47). In other human research, Spirulina platensis showed a preventive effect of the skeletal muscle damage that, according to the authors, may have led to postponement of the time of exhaustion during the all-out exercise (23).

CalciumCalcium: In a weight-loss study of 15 volunteers receiving 200mg of spirulina tablets for four weeks, small statistically significant increases in serum calcium were detected (69). Individuals had also been on reduced-calorie diets with unclear constituents. Concomitant use with calcium supplements may theoretically increase serum levels beyond expected results. In addition, hypercalcemia has been reported in newborns when the mother was taking Spirulina supplements (77).

Cardiovascular agentsCardiovascular agents: Theoretically, spirulina may have additive effects when taken with ACE inhibitors. According to in vitro research, spirulina may contain beneficial constituents for the production of ACE inhibitory peptides by proteolysis (70).

ChromiumChromium: In laboratory research, Spirulina fusiformis has been reported to be effective in the removal of chromium and other metal ions (120; 121). In an in vitro study, Cyanothece 16Som 2 had an affinity for chromium (2-50x) (55).

CopperCopper: In laboratory research, Spirulina fusiformis has been reported to be effective in the removal of copper and other metal ions (120). In an in vitro study, two cyanobacteria strains demonstrated the ability to bind and remove heavy metals. Cyanothece 16Som 2 had an affinity for chromium (2-50x) and copper (1.5-20x), while Nostoc PCC 7936 was strongly selective for copper (55).

Cytochrome P450-modifying agentsCytochrome P450-modifying agents: In animal research, gastric intubation with spirulina suspension for 15 days led to a decrease in the hepatic content of cytochrome P450 enzymes and an increase of glutathione S-transferase activity (45). Theoretically, spirulina may interact with other cytochrome P450-modifying agents.

Gamma-linolenic acidGamma-linolenic acid: Theoretically, spirulina may have additive effects when taken with certain vitamins, including gamma-linolenic acid or gamma-linolenic acid-containing foods.

Gastrointestinal agentsGastrointestinal agents: In animal research, Spirulina maxima in the diet increased the amount of fat in the feces; reduced plasma, liver, and heart alpha-tocopherol levels; and increased liver retinoid levels at low concentrations (113). Spirulina platensis has been shown to stimulate the in vitro growth of lactic acid bacteria, which may explain the use of spirulina as a digestive aid (114). In animal research, gastric intubation with spirulina suspension for 15 days led to a decrease in the hepatic content of cytochrome P450 enzymes and an increase of glutathione S-transferase activity (45). Reports of laboratory research stated that polysaccharides derived from spirulina may function as a potential antiadhesive agent against H. pylori colonization of gastric mucin (25).

HepaticsHepatics: Carotenoids extracted from Spirulina platensis and Dunaliella salina have been proposed to have hepatoprotective activity (27). In laboratory research, selenium-rich Spirulina platensis displayed antagonistic effects to liver fibrosis, which, according to the authors, may suggest that enhancement of antioxidation levels and liver reserve function might be associated with these effects (20).

ImmunostimulantsImmunostimulants: In animal research, spirulina displayed immunostimulatory effects (62). A study in mice demonstrated that Spirulina fusiformis 400 or 800mg/kg of body weight significantly decreased immune response. An in vitro study carried out by the same investigators demonstrated that 50 or 100mcg/mL of Spirulina fusiformis inhibited mitogen (phytohemagglutinin)-induced proliferation of T lymphocytes (115). A pilot study followed by a randomized controlled trial by the same investigators assessed the effects of spirulina on immune function and reported an increase in natural killer (NK) cell activity (86). In human research, treatment with spirulina caused a significant increase in IL-2 and a slight but statistically insignificant change in IL-6 (48).

ImmunosuppressantsImmunosuppressants: There is evidence from an animal study that spirulina may have an immune-enhancing effect and theoretically may interfere with immunosuppressive therapy (62). A study in mice demonstrated that Spirulina fusiformis 400 or 800mg/kg of body weight significantly decreased immune response. An in vitro study carried out by the same investigators demonstrated that 50 or 100mcg/mL of Spirulina fusiformis inhibited mitogen (phytohemagglutinin)-induced proliferation of T lymphocytes (115). A pilot study followed by a randomized controlled trial by the same investigators assessed the effects of spirulina on immune function and reported an increase in natural killer (NK) cell activity (86). In human research, treatment with spirulina caused a significant increase in IL-2 and a slight but statistically insignificant change in IL-6 (48).

IronIron: In animal research, iron availability from Spirulina platensis was equivalent to that of iron sulfate (34) and improved iron status when used during pregnancy and lactation (35). Theoretically, spirulina may have additive effects when taken with iron or iron-containing foods.

Neurologic agentsNeurologic agents: Spirulina maxima may have a neuroprotective role. In animal research, spirulina partially prevented the dopamine-depleting effect of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and blocked oxidative stress in a model of Parkinson's disease (43). A study using a combination herbal product that included Spirulina platensis demonstrated an improvement in attention in ADHD patients; however, the effect of spirulina alone was unclear (68). In human research, supplementation with Klamath algae decreased the menopausal symptoms of anxiety, depression, and somatization (89).

NickelNickel: Spirulina fusiformis has been reported to be effective in the removal of nickel and other metal ions (120).

Vitamin EVitamin E: Spirulina maxima, when fed to adult male rats in varying concentrations, has been shown to alter the storage and utilization of vitamin A and vitamin E (113).

VitaminsVitamins: Spirulina may have additive effects when taken with certain vitamins, including iron, gamma-linolenic fatty acid, carotenoids, thiamin (vitamin B1), riboflavin (vitamin B2), vitamin B12, and vitamin E. In theory, spirulina may increase blood calcium to unsafe levels if calcium supplements are also used. A systematic review reported improvements in weight and height of children suffering from malnutrition that took spirulina (74), and an open-label study demonstrated improvement in vitamin B12 and homocysteine levels in subjects taking an algae combination product (88).

Alkaline phosphataseAlkaline phosphatase: In a weight-loss study of 15 volunteers receiving 200mg of spirulina tablets for four weeks, small statistically significant increases in alkaline phosphatase were detected (69). These individuals had also been on a reduced-calorie diet. There was a lack of documented follow-up.

Blood pressureBlood pressure: Theoretically, spirulina may have additive effects when taken with ACE inhibitors. Spirulina may contain beneficial constituents for the production of ACE inhibitory peptides by proteolysis (70). In clinical research, spirulina lowered blood pressure (49).

CytokinesCytokines: In human research, spirulina significantly increased IL-2 in men and women and caused a slight but statistically insignificant change in IL-6 (48). In patients with allergic rhinitis, spirulina significantly reduced interleukin-4 levels (80). In other research, spirulina was found to be ineffective at modulating the secretion of Th1 cytokines (IFN-gamma and IL-2); however, when administered at 2,000mg daily, spirulina reduced the production of interleukin-4 (IL-4) by peripheral blood mononuclear cells in subjects with allergic rhinitis (80). Spirulina has been found in vitro and in vivo to inhibit the production of tumor necrosis factor-alpha (9). In animal research, the application of Spirulina-Dunaliella algae extract to buccal pouch carcinoma in hamsters induced tumor necrosis factor (TNF)-alpha production and promoted tumor regression (16). Spirulina platensis has been demonstrated in vitro to stimulate macrophages, phagocytosis, and interleukin-1 production (31). The ex vivo production of IgA and IL-6 from Peyer's patch cells was enhanced twofold and interferon-gamma production from spleen cells was increased fourfold in ImmulinaT-treated mice (124). Also, ImmulinaT dose-dependently increased the expression of interleukin (IL)-8, MCP-1, MIP-1alpha, MIP-1beta, and IP-10, as well as the expression of TNF-alpha, IL-1beta, and COX-2 in vitro. A cytokine array immunoblot assay revealed an increase in the chemokines IL-8 and MIP-1beta. Thymidine uptake experiments verified that ImmulinaT lacked an effect on the viability and growth rate of THP-1 cells (30).

Heavy metals panelHeavy metals panel: Spirulina fusiformis has been reported to be effective in the removal of chromium (121), cadmium (125), nickel, copper, and other metal ions (120). Spirulina may also demonstrate a protective effect against the lead-induced increase in mast cells in the ovary during the estrous cycle of rats (126). In an in vitro study, Cyanothece 16Som 2 had an affinity for chromium (2-50x) and copper (1.5-20x), while Nostoc PCC 7936 was strongly selective for copper (55).

Immunoglobulins (IgA)Immunoglobulins (IgA): The ex vivo production of IgA and IL-6 from Peyer's patch cells was enhanced twofold and interferon-gamma production from spleen cells was increased fourfold in ImmulinaT-treated mice (124).

Immunoglobulins (IgE)Immunoglobulins (IgE): In a poorly described controlled human study, children exposed to radiation during the Chernobyl nuclear accident who were given daily spirulina (1,250mg for ages 3-5 and 1,750mg for ages 5-7) showed a significant decrease in serum IgE levels (44). Spirulina platensis has also been shown to inhibit IgE-mediated histamine release from activated mast cells in rats, preventing anaphylactic reactions after exposure with a known allergen (10).

Serum calciumSerum calcium: In a weight-loss study of 15 volunteers receiving 200mg spirulina tablets for four weeks, small, statistically significant increases in serum calcium were detected (69). These individuals had also been on a reduced-calorie diet with unclear constituents. There was a lack of documented follow-up.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.